NPs are advanced practice nurses who play a critical role in today’s healthcare system, often filling crucial gaps in primary care.
But how does an NP compare to an MD? While these two professions are both qualified to diagnose, manage, and treat a range of acute and critical health conditions, how do their differences in training, day-to-day responsibilities, and overall approach to patient care differ?
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What is an NP?
An NP is an advanced practice nurse who has completed either a master’s degree in nursing (MSN) or a doctorate in nursing practice (DNP). This advanced education allows NPs to provide services that registered nurses cannot.
NPs can provide much of the same care as doctors can, including managing preventative care, diagnosing and treating acute and chronic illnesses, and performing some procedures, such as biopsies or suturing wounds. NPs can also prescribe medication and order and interpret labs and other diagnostic tests.
NPs can work in various settings, including hospitals, clinics, nursing homes, emergency rooms, and doctors’ offices. An NP’s scope of practice is dictated by the nursing board of the state where they are licensed. While many states require NPs to work under the supervision of a physician, others allow NPs full practice authority, meaning they can open their own private practices.
NP Specialties
NP specializations generally focus on different patient populations or areas of care and include:
- Adult Gerontology (AGNP): This type of NP focuses on the care of teens, young adults, adults, and seniors. They can generally focus on acute care and managing acute, complex, and more critical conditions, or primary care, which focuses more on non-urgent or preventive care.
- Family Nurse Practitioner (FNP): An FNP is trained to care for patients of all ages, from infants to seniors, and commonly provides comprehensive care. Because of their broad scope of practice, FNPs are in high demand, particularly in areas where there is a shortage of primary care doctors.
- Neonatal Nurse Practitioner (NNP): NNPs work with infants up to two years of age. Many work in NICUs, and they are specially prepared to work with infants who have been born prematurely or who have an acute illness or other health condition that requires specialty care.
- Pediatric Nurse Practitioner (PNP): Pediatric NPs work with pediatric patients and, like AGNPs, can specialize in acute and primary care.
- Psychiatric Nurse Practitioner (PMHNP): PMHNPs provide mental health care to children, adults, and families, working with people with mental health conditions for substance use disorders.
- Women’s Health Nurse Practitioner (WHNP): NPs in this field provide gynecological and reproductive care to women, but they are not qualified to deliver babies.
Becoming an NP
There are a few pathways to becoming a nurse practitioner. One of the most common is to pursue a BSN, pass the NCLEX exam, and then apply to a master’s or doctorate program in the specialty you’re interested in. Some NP programs require work experience, and many employers provide reimbursement for nursing education. As a result, many RNs choose to work while pursuing their NP degree. Many online NP programs support this by offering flexible and weekend classes or having minimal on-campus requirements for NP students.
Nurses with associate’s degrees or diplomas have options, too. RN-to-BSN programs are available for nurses who want to complete a BSN on their way to their NP degree, but there are also RN-to-NP and even RN-to-DNP programs available.
What is an MD?
MD stands for medical doctor. In their training, they focus on a broad scope of knowledge, with a particular emphasis on the disease process. They can diagnose and treat illnesses, prescribe medication, and perform a number of other procedures and interventions, depending on their specialization.
MDs can practice independently in any state and work in a variety of settings depending on their specialization, including hospitals, clinics, private practices, surgery centers, and more.
Becoming an MD
Becoming a medical doctor requires extensive education. Students generally complete a bachelor’s degree in pre-med or a related field and have to take the Medical College Admission Test (MCAT) before applying to medical school.
Most medical school programs are four years, consisting of classroom and clinical experiences in a variety of community and healthcare settings. Medical school covers a wide range of subjects, including anatomy, physiology, pharmacology, problem-solving, disease processes, diagnostics, prevention, and treatment.
In the last year of medical school, students choose a specialty and begin to focus on specialty-focused skills before being matched to a residency program. Residency takes 3 to 7 years, depending on the specialty, where they get hands-on training and experience. Some students choose to add a fellowship, which is 1 to 3 more years focused on their speciality area.
Major differences between an NP and an MD
The main differences between an NP and an MD relate to their education.
Length of education and clinical hours
Depending on the route they take, most NPs can complete their education in about 7 to 8 years. Throughout their entire education, they typically complete anywhere from 1500 to 1800 clinical hours.
On the other hand, MDs are in school anywhere from 7 to 15 years and complete 12,000 to 16,000 hours of hands-on hours, which is significantly more than an NP. That said, it’s worth noting that many of the doctors who train for longer periods of time specialize in areas like neurosurgery or cardiac surgery.
Though their scopes of practice differ, the medical specialty that is most similar to an NP is primary care. Most primary care residencies last about 3 years, which means that a primary care physician would have at least 7 years of medical school education on top of four years of undergraduate work.
The nursing model vs the medical model
NPs and MDs are trained using different approaches to patient care.
The nursing model of care is rooted in the nursing process. All NPs start as RNs, and the foundation of their education lies in this approach.
The nursing model has five steps: assessment, diagnosis, planning, implementation, and evaluation, and focuses mainly on Maslow’s Hierarchy of Needs. Although NPs diagnose and treat medical conditions, their care is still rooted in a holistic approach. They consider the whole person, including their mental and social health, as well as symptoms and the disease process.
MDs are trained using a medical model, which focuses on the fundamentals of disease and pathology. They gain a deep understanding of what is occurring during the disease process, which helps them determine a diagnosis and the appropriate treatment. This model focuses on creating a differential diagnosis to determine a patient’s condition and ordering appropriate diagnostic tests to arrive at a diagnosis and establish a treatment plan.
This is not to say that NPs are not capable of diagnosing a condition using critical thinking and diagnostic tests or that MDs do not care for the whole patient, only that the basis of their training varies.
Takeaway
While NPs and MDs both diagnose and treat patients, their philosophies, education, training, and responsibilities vary, and they may take very different approaches to patient care. That said, with the changing healthcare climate and gaps in primary care predicted for the future, NPs and MDs both fill critical roles and are essential to providing necessary healthcare services.